Methodology for assessing the hardness of scar-altered integuments of the stump

Authors:

Smirnova Ludmila Mihailovna – Grand PhD in Engineering sciences (Dr. Ing. Sci), leading researcher of the Department of Biomechanical Studies of the Musculoskeletal System of Institute of Prosthetics and Orthotics, Albrecht Federal Scientific and Educational Centre of Medical and Social Expertise and Rehabilitation, Bestuzhevskaya Street, 50, 195067 St. Petersburg, Russian Federation; Professor of Department of Bioengineering systems, St. Petersburg Electrotechnical University, 5 Professora Popova Street, 197376, St. Petersburg, Russian Federation; e-mail: info@diaserv.ru; https://orcid.org/0000-0003-4373-9342.

Ponomarenko Gennadiy Nikolaevich – Corresponding Member of the Russian Academy of Sciences, Honored Scientist of the Russian Federation, Grand PhD in Medical sciences (Dr. Med. Sci), Professor, Director General of the Albrecht Federal Scientific and Educational Centre of Medical and Social Expertise and Rehabilitation, Bestuzhevskaya Street, 50, 195067 St. Petersburg, Russian Federation; e-mail: ponomarenko_g@mail.ru; https://orcid.org/0000-0001-7853-4473.

Ponomarenko Inga Gennadievna – Grand PhD in Medical sciences (Dr. Med. Sci), Professor of the Department of Physical and Rehabilitation Medicine of North-Western State Medical University named after I.I. Mechnikov, Kirochnaya Street, 41, St. Petersburg, 191015, Russian Federation; Associate Professor, Department of Skin and Venereal Diseases, Military Medical Academy named after S.M. Kirov, Academician Lebedev street, St. Petersburg, 194044, Russian Federation; e-mail: manga-85@mail.ru; https://orcid.org/0000-0001-6550-6940.

Sokurov Andrey Vladimirovich – Grand PhD in Medical sciences (Dr. Med. Sci), Associate Professor, Director of the Institute of Further Professional Education, Albrecht Federal Scientific and Educational Centre of Medical and Social Expertise and Rehabilitation, 50 Bestuzhevskaya Street, 195067 St. Petersburg, Russian Federation; e-mail: ansokurov@yandex.ru; http://orcid.org/0000-0001-5621-0240.

Annotation:

Introduction. Scarring of the skin covers is formed annually in more than 100 million patients, in 5-15 % of cases – pathological, reducing the quality of life of patients. Scarring on the lower limb stump significantly complicates prosthetics and reduces its functional results. Especially often they are formed in mine-explosive wounds. Due to the sharp increase in the number of patients affected by the consequences of military operations and military trauma, the development of methods for assessing the mechanical properties of scarring of the skin covers at the stages of diagnosis and their correction has acquired a particularly high relevance.

Aim – justification of the method for assessing the hardness of human skin in vivo.

Materials and methods: the paper presents a method for measuring the hardness of human skin scars in vivo using the Shore indentation method.

Results. The method of studying the mechanical properties of the scar of the skin in vivo by the method of indentation according to Shore with an assessment of the depth of penetration of the indenter at a certain load is substantiated and tested. A modified durometer is used to measure the hardness (transverse elasticity) of scarred tissues. Device specifications: indenter diameter – 2.38+0.15 mm; indenter tip shape – sphere with a diameter of 2.38+0.15 mm; maximum possible pressing force achieved when the indenter is inserted into the device cavity to the level of the support pad plane – 0.1 kg; indenter offset – 0-2.5 mm.

Discussion. The introduction of an indenter into a material causes compression, tension and shear deformation, the modules of which are related to each other. But even if the relations between these parameters were known, knowing some of them, it would not be possible to calculate the others by Hooke’s law, since it does not hold for objects with anisotropic properties, and it is precisely such objects that are the scars of human skin. Therefore, when studying their mechanical properties, it is more correct to specify directly the parameters that were measured in the experiment, rather than using the terms “elastic modulus” (Young’s modulus) that are commonly used in engineering for homogeneous materials.

Conclusion. The proposed method for measuring the hardness of human skin scars allows for in vivo quantification of the effectiveness of scar correction in dermatology, aesthetic medicine, and limb prosthetics.

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